Active NPI
Anthony James Bellomo, LMSW
- Counselor
- Patchogue, NY
National Provider Identifier
1952810806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 100964
- Practice address
- 475 E Main St # 11772
Patchogue, NY 11772-3121 - Phone
- (631) 363-2001
- Fax
- (631) 702-8049
- NPI assigned
- Sep 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 100964 | NY | Primary |
Addresses
Primary practice location
475 E Main St # 11772
Patchogue, NY 11772-3121
Mailing address
1500 Route 112 BLDG 4
Suite101
Port Jefferson Station, NY 11776
Phone (631) 751-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100964 | NY | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1952810806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ROUTE 112 BLDG 4",
"address_2": "SUITE101",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-751-3000",
"fax_number": "631-509-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 E MAIN ST # 11772",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117723121",
"telephone_number": "631-363-2001",
"fax_number": "631-702-8049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLOMO",
"first_name": "ANTHONY",
"middle_name": "JAMES",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-22",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": "100964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.